Tele-odontology in Brazil: Strategies and Challenges for the Training of the Healthcare Network

Different initiatives have been undertaken to guide the telehealth process in the Brazil. The Ministry of Health structured and implemented the Telehealth Brazil Programme initially to cover nine state centres. Later, it expanded the programme to take in the whole country, at which time it became known as the Telehealth Brazil Network. Among the goals of the Telehealth Brazil Network is the development of strategies for clinical training, health education, and training for management, planning and assessment skills, designed for the Family Health Strategy teams. In this context, this paper aims to presents the potential of and difficulties in implementing tele-odontology in Brazil, focusing on teleconsulting, tele-education and telediagnostic experiences developed to date. It will also present the legal and financial support aspects established in the country, as well as the results found so far in relation to the impacts of strategies and user satisfaction. Finally, suggestions for future perspectives are presented. Related to the strategies implemented in Brazil, it is necessary to analyse the data obtained regarding the successes and failures observed over the years. The positive results obtained with tele-education showed that the Telehealth Programme presents as an efficient tool for the training of the health care network. However, points like the limited use by professionals, some technical limitations and the impact on health indicators should still be better studied

A enfermagem e a política nacional de formação dos profissionais de saúde para o SUS

El presente artículo tiene por objetivo identificar aspectos y características de las formulaciones e implementación de la Política Nacional de Gestión de la Educación en Salud a lo largo de los últimos seis años, destacando la participación y el rol central de la carrera y la profesión de Enfermería como campo de conocimiento estructurador de la gestión del cuidado y del proceso de trabajo en la salud. Se resaltan los avances y desafíos enfrentados en la actualidad para la consolidación del SUS y el papel de la articulación entre los administradores de salud y de la educación, y del establecimiento de la articulación inter-federativa para el éxito de las iniciativas en curso.The objective of the present article is to identify the aspects and characteristic of creating and implementing the national policy for the administration of health education, over the last six years, with particular emphasis on the central role of nursing undergraduate studied and the profession as a field of knowledge that structures the management of care and the working process in health. The advancements and the current challenges that are posed to implement the National Health System and the role of connecting health care and education administrators and establishing an interfederal network to assure the success of the ongoing initiatives.O presente artigo tem por objetivo identificar aspectos e características da formulação e implementação da política nacional de gestão da educação na saúde, ao longo dos últimos 6 anos, destacando a participação e o papel central da graduação e da profissão da Enfermagem como campo de conhecimento estruturante da gestão do cuidado e do processo de trabalho na saúde. Ressaltam-se os avanços e desafios atualmente colocados para a consolidação do SUS e o papel da articulação entre os gestores da saúde e da educação, e do estabelecimento da articulação interfederativa para o sucesso das iniciativas em curso

Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brazil Networks Programme

Telehealth has been applied in the Unified Health System (SUS) as a tool for qualifying professionals and improving the healthcare provided to the population served by the system. The aim of the present study was to evaluate the impact of teleconsultations on the qualifications of the clinical approach of the oral health teams involved in primary health care (PHC) in the state of Rio Grande do Sul under the Telehealth Brazil Networks Programme. The sample population of the study was composed of 285 dentists and 132 oral health assistants belonging to the Family Health Teams. A chi-square test was used to investigate possible associations between the absolute number of teleconsultations performed and several independent variables, namely, gender, age, dental specialty, time since graduation, time working in the Family Health Strategy (FHS), employment status, type of training institution, familiarity with information technology, and work satisfaction at the health facility. The level of significance was p < 0.05. Use of the oral health teleconsultation service led to a reduction of more than 45% in the number of referrals to other levels of care. However, no significant association was found between the number of teleconsultations and the independent variables analysed. The use of teleconsultations proved to be a powerful tool for professional training, for increasing the effectiveness of PHC, and for improving the oral healthcare provided

Feminisation of Dentistry in Brazil from the Perspective of a MOOC-Type Distance Course - A Short Report

The Brazilian public healthcare system (SUS - Brazilian Healthcare System) provides free dental care, covering almost half of the Brazilian population. Providing continuing education to thousands of professionals is a difficult and expensive task given the country’s large size. SUS' Open University in partnership with public universities provides ongoing education to thousands of healthcare professionals using technological resources for distance learning. A distance learning course, in the MOOC (Massive Open Online Course) modality, was developed to provide continuing medical education for dental surgeons to assist patients with chronic diseases. The course is free and has registered 13,089 participants. Aim: The purpose of this study is to present the profile of the MOOC course participants. Methods: Secondary data were obtained from Federal Council of Dentistry, the National Registry of Health Facilities, the National Institute for Educational Studies and Research Anísio Teixeira and the Registry of Higher Education Institutions and Courses (e-MEC). Data of the MOOC course were collected in the Arouca Platform. Results: Dentists in Brazil are predominantly female. However, in some specialties there are more men than women. The majority of participants on the course were female 73.5% and in the age group of 21-40 years. Conclusion: This phenomenon is similar to other countries, and needs to be better investigated in Brazil, so that public policies of continuing education of healthcare professionals by means of distance learning, may take the profession's feminisation into consideration. &nbsp

Follow up of the Legislation Advancement Along the Implementation of the Brazilian Telehealth Programme

Purpose: Brazil has adopted e-Health as a national policy applied to healthcare and education since 2006. The aim of the present study is to present the evolution of the legislation as it reflects the evolution of the Brazilian Telehealth Program along this period of time, as well as some learned lessons. Methods: To describe the evolution of the program, a model was adopted, and analysed  in parallel to the three main edicts that oriented the evolution of the  program. Results: The life cycle stages of e-health implementation were identified in the evolution of the 3 different stages of the Brazilian Telehealth Program and also reflected in the evolution of its legislation. The results of pilot project from the first stage was followed and guided the implementation of the National Program applied to primary health care in the second stage. The Program has been implemented all over the country, developed new concepts, became integrated to the Unified Health Systems not only in primary health care, but also include median and high complexity level of care. Conclusion: The Brazilian Telehealth Program, along his implementation and consolidation, established new concepts and had telehealth included in its roll of services. These accomplishments are reflected in the Brazilian legislation, which considers and applies e-Health as a national policy

Open Applications developed in Brazil for Distant Learning in Dentistry: Valuable Educational Resources for Academic Professional Qualification

Technology Enabled Learning, distance learning that leverages Information and Communication Technologies (ICT), has enabled thousands of individuals to access educational content, , and encouraged many educational institutions to adopt this modality. In Brazil, in order to promote Permanent Education in Health  or continuing professional development (CPD) of professionals working in the public health sector, the government created the Open University of Brazilian National Health System (UNA-SUS), which  offers postgraduate, updating and improvement courses, focusing on public and community health. In addition, to improve quality in Primary Care service inside SUS, Brazil developed the Telehealth Networks Programme; a national program that integrates teaching and service through ICT, offering conditions to promote Telecare and Tele-education. A challenge in consolidating these initiatives is to service professionals working in remote areas, precisely those who need CPD the most. To address this problem, UNA-SUS collaborated with Federal University of Maranhão (UFMA) to develop applications for mobile devices available through the SAITE Store platform. This makes the educational content created by the institution available both online and offline, and using different types of devices.  Recognising Dentistry as a primary healthcare component, UNA-SUS/UFMA developed applications for this specific area. The content is multidisciplinary, presenting relevant information to the various professionals who provide primary care services in dental care within the healthcare network. This paper describes the history of the partnership between UNA-SUS/UFMA, the focus on dentistry and alignment with the Faculty of Dentistry of the University of São Paulo (FOUSP) Teledentistry programme,  the rationale and production process of mobile applications by UNA-SUS/UFMA, and their relevance  for academic and professional qualification of primary healthcare workers throughout Brazil

Restoring High Vaccine Coverage in Brazil: Successes and Challenges

Facing the decline in vaccine coverage observed since 2016, the new Brazilian government committed to reversing this scenario. To achieve this, the Federal Government launched the National Vaccination Movement and the 'Health with Science' platform to combat vaccine misinformation, promoted Microplanning, providing tools for decision-making at the territorial level, allocated 30 million dollars to states and municipalities to implement innovative vaccination strategies, standardized the rules of the information systems for the registration of vaccine doses, and directed data to the National Health Data Network (RNDS). Reversing the declining trend of vaccination coverage in Brazil is challenging, but within just one year, it is possible to observe significant results from governmental actions. Out of the eight recommended vaccines by the age of one, seven showed an increase in vaccination coverage in 2023 compared to 2022: Most states showed improvements in vaccination coverage. Many challenges persist in advancing the vaccination agenda. However, there are reasons to celebrate the reversal of the declining trend in coverage of several vaccines in this first year of government and the increase in the number of municipalities that have fully achieved the vaccination coverage target. The National Vaccination Movement, with public opinion awareness, the resumption of regionalized communication campaigns, localized micro-planning actions including extramural vaccination strategies, and the integration of information systems, has been decisive in strengthening work in the territories and thus restoring a culture of immunization, a source of pride in the country and internationally recognized, throughout the 50 years of the National Immunization Progra